Automated Overnight Closed-Loop Control Using a Proportional-Integral-Derivative Algorithm with Insulin Feedback in Children and Adolescents with Type 1 Diabetes at Diabetes Camp

作者:Ly, Trang T.; Keenan, D. Barry; Roy, Anirban; Han, Jino; Grosman, Benyamin; Cantwell, Martin; Kurtz, Natalie; von Eyben, Rie; Clinton, Paula; Wilson, Darrell M.; Buckingham, Bruce A.*
来源:Diabetes Technology & Therapeutics, 2016, 18(6): 377-384.
DOI:10.1089/dia.2015.0431

摘要

Objective: This study determined the feasibility and efficacy of an automated proportional-integral-derivative with insulin feedback (PID-IFB) controller in overnight closed-loop (OCL) control of children and adolescents with type 1 diabetes over multiple days in a diabetes camp setting. Research Design and Methods: The Medtronic (Northridge, CA) Android (TM) (Google, Mountain View, CA)-based PID-IFB system consists of the Medtronic Minimed Revel (TM) 2.0 pump and Enlite (TM) sensor, a control algorithm residing on an Android phone, a translator, and remote monitoring capabilities. An inpatient study was completed for 16 participants to determine feasibility. For the camp study, subjects with type 1 diabetes were randomized to either OCL or sensor-augmented pump therapy (control conditions) per night for up to 6 nights at diabetes camp. Results: During the camp study, 21 subjects completed 50 OCL nights and 52 control nights. Based on intention to treat, the median time spent in range, from 70 to 150mg/dL, was greater during OCL at 66.4% (n = 55) versus 50.6% (n = 52) during the control period (P = 0.004). A per-protocol analysis allowed for assessment of algorithm performance with the median percentage time in range, 70-150mg/dL, being 75.5% (n = 37) for OCL versus 47.6% (n = 32) for the control period (P < 0.001). There was less time spent in the hypoglycemic ranges <60mg/dL and <70 mg/dL during OCL compared with the control period (P = 0.003 and P < 0.001, respectively). Conclusions: The PID-IFB controller is effective in improving time spent in range as well as reducing nocturnal hypoglycemia during the overnight period in children and adolescents with type 1 diabetes in a diabetes camp setting.

  • 出版日期2016-6